School Location Analysis by Integrating the Accessibility, Natural and Biological Hazards to Support Equal Access to Education

This study proposes a new model for land suitability for educational facilities based on spatial product development to determine the optimal locations for achieving education targets in West Java, Indonesia. Single-aspect approaches, such as accessibility and spatial hazard analyses, have not been widely applied in suitability assessments on the location of educational facilities. Model development was performed based on analyses of the economic value of the land and on the integration of various parameters across three main aspects: accessibility, comfort, and a multi-natural/biohazard (disaster) risk index. Based on the maps of disaster hazards, higher flood-prone areas are found to be in gentle slopes and located in large cities. Higher risks of landslides are spread throughout the study area, while higher levels of earthquake risk are predominantly in the south, close to the active faults and megathrusts present. Presently, many schools are located in very high vulnerability zones (2057 elementary, 572 junior high, 157 senior high, and 313 vocational high schools). The comfort-level map revealed 13,459 schools located in areas with very low and low comfort levels, whereas only 2377 schools are in locations of high or very high comfort levels. Based on the school accessibility map, higher levels are located in the larger cities of West Java, whereas schools with lower accessibility are documented far from these urban areas. In particular, senior high school accessibility is predominant in areas of lower accessibility levels, as there are comparatively fewer facilities available in West Java. Overall, higher levels of suitability are spread throughout West Java. These distribution results revealed an expansion of the availability of schools by area: senior high schools, 303,973.1 ha; vocational high schools, 94,170.51 ha; and junior high schools, 12,981.78 ha. Changes in elementary schools (3936.69 ha) were insignificant, as the current number of elementary schools is relatively much higher. This study represents the first to attempt to integrate these four parameters—accessibility, multi natural hazard, biohazard, comfort index, and land value—to determine potential areas for new schools to achieve educational equity targets.

“You haven’t gone out and done anything”: Exploring Disabled Veterans Experiences in Higher Education

Through the analysis of 24 in-depth, semi-structured interviews, this study explored the process through which disability affects veterans’ experiences in the university classroom and their social relations with traditional students. Using inductive-exploratory qualitative methods, this study builds upon the sociological understanding of veterans’ experiences in higher education. Findings from this study tentatively suggest that while disability related fear/hypervigilance, stigma, and anxiety significantly impact veterans’ comfort levels when engaging with traditional students, veterans also externalize the impact of their disability as a social artifact of their military service. More research is needed to determine if the interaction of disability and artifacts of service decreases veterans’ ability to integrate well with traditional students in classroom settings.

A Continuing Education Activity Durably Addressed Knowledge Gaps Related to Penicillin Allergies Among Pharmacists and Pharmacy Technicians

Background: Penicillin allergy is one of the most frequent self-reported allergies; however, only about 10% of reported allergies are accurate. Objectives: Through the creation of a continuing pharmacy education (CPE) activity, we sought to assess knowledge gaps and comfort levels in the management of penicillin allergies. Methods: A 1-hour enduring-content CPE activity was offered as an interactive course from September 20, 2019, to September 20, 2020. Participants completed 3 surveys (pre-survey, post-survey, and follow-up survey). Participants were pharmacists and pharmacy technicians who completed, at a minimum, the activity and both pre- and post-surveys. The primary outcome was the percentage of participants scoring >80% on knowledge-based questions on the post-survey compared with the pre-survey. Secondary outcomes included pre-post comparisons on knowledge-based questions, participants’ self-report of an allergy, and comfort levels dispensing cephalosporins in a patient with a self-reported penicillin allergy. Results: A total of 389 participants completed the CPE activity, with 176 included for analysis. Significantly more participants scored >80% on knowledge-based questions on the post-survey compared with the pre-survey (71.6% vs 22.7%, P < .001). There was no significant difference between the percentage of participants scoring >80% on the post-survey and the follow-up survey (71.6% vs 65%, P = .119). The majority of participants (74%) felt comfortable dispensing a cephalosporin in a patient with a penicillin allergy on the pre-survey, with similar percentages on the post- and follow-up surveys (77% and 90%, respectively). Conclusion: A targeted continuing education program improved overall knowledge, which was sustained for up to 2 months.

Multimodal Active Shooter Training for Emergency Department Personnel: An Initiative for Knowledge, Comfort, and Retention

Background: While hospital-related shootings are not common, recent years have demonstrated an increasing trend, especially involving the emergency department (ED). Despite this increase, there remains a lack of effective training for providers for active shooter events. Existing trainings commonly lack active participation, departmental-specific plans, or feasibility. Methods: Sixty-six emergency medicine physicians, nurses, and technicians participated in a two-phased multimodal active shooter training aimed to increase response knowledge and comfort. The initial training phase included a lecture on “Run-Hide-Fight” principles with departmental adaptations, followed by scenario-based discussion, and then safety walkthrough. Months later in the second phase, participants completed an active shooter simulation. An identical knowledge survey was collected before and after each phase along with descriptive analysis. Surveys were compared using paired t-test. Comfort levels were reported on a Likert scale and compared by paired t-test. Results: Paired t-tests confirmed a statistically significant difference in both active shooter knowledge and comfort levels. Participants showed retention of response knowledge and comfort with implementing response behaviors. Further descriptive analysis demonstrated effective fleeing and barricading, suggesting a real-life gain of knowledge and comfort. Conclusion: A two-phased, multimodal training design for active shooter response was successful in increasing ED provider active shooter knowledge, comfort, retention, and effective response behaviors.

Influence of Postponed Follow-Up after Cochlear Implant Activation during the COVID-19 Pandemic on Aided Sound Field Detection and Speech Recognition

<b><i>Introduction:</i></b> The objective of this study was to assess the influence of postponing the first post-activation follow-up due to the COVID-19 pandemic on the aided sound field detection thresholds and speech recognition of cochlear implant (CI) users. <b><i>Methods:</i></b> A retrospective review was performed at a tertiary referral center. Two groups of adult CI recipients were evaluated: (1) patients whose first post-activation follow-up was postponed due to COVID-19 closures (postponed group; <i>n</i> = 10) and (2) a control group that attended recommended post-activation follow-ups prior to the COVID-19 pandemic (control group; <i>n</i> = 18). For both groups, electric thresholds were estimated at initial activation based on comfort levels and were measured behaviorally at subsequent post-activation follow-ups. For the control group, behavioral thresholds were measured at the 1-month follow-up. For the postponed group, behavioral thresholds were not measured until 3 months post-activation since the 1-month follow-up was postponed. The aided pure-tone average (PTA) and word recognition results were compared between groups at the 3-month follow-up and at an interim visit 2–9 weeks later. <b><i>Results:</i></b> At the 3-month follow-up, the postponed group had significantly poorer word recognition (23 vs. 42%, <i>p</i> = 0.027) and aided PTA (42 vs. 37 dB HL, <i>p</i> = 0.041) than the control group. No significant differences were observed between 3-month data from the control group and interim data from the postponed group. <b><i>Conclusions:</i></b> The postponed follow-up after CI activation was associated with poorer outcomes, both in terms of speech recognition and aided audibility. However, these detrimental effects were reversed following provision of an individualized map, with behaviorally measured electric threshold and comfort levels. While adult CI recipients demonstrate an improvement in speech recognition with estimated electric thresholds, the present results suggest that behavioral mapping within the initial weeks of device use may support optimal outcomes.

Derivation of Spatially Distributed Thermal Comfort Levels in Jordan as Investigated From Remote Sensing, GIS Tools and Computational Methods

Thermal comfort is usually calculated using discrete point measurements. This procedure is not suitable to study thermal comfort for inhabited areas with rugged terrains where climate gradient is high. The wide availability of remote sensing data and GIS tools have revolutionized data management, processing and visualization. The present paper implemented digital elevation data, GIS tools and a computational algorithm to generate spatially continuous maps of climatological elements which were employed to derive thermal comfort levels across Jordan. Results show detailed information of the spatial distribution of the degree of thermal comfort in winter and summer across the country which cannot be resolved using discrete point measurements. It is shown that the mountainous areas in the country, where most urban centers are situated, experience “slightly warm” to “warm” indoor apparent temperatures in summer. The Jordan Valley and the desert experience high indoor apparent temperatures in summer. Cold conditions prevail over most parts of the country, with the heating degree days ranging from 2100 in the southern mountains to values close to zero near the Dead Sea area. The presented procedure demonstrated that the very low levels of ambient vapor pressure is an important atmospheric forcing contributing to the widespread cold conditions prevailing over the desert areas in winter. The efficiency of direct evaporative cooling systems to achieve thermal comfort in the various parts of the country is investigated. The procedure presented can be used over regional scales with different levels of spatial resolutions for a wide range of climatological studies.

Effect of roof colour on indoor temperature and human comfort levels, with implications for malaria control: a pilot study using experimental houses in rural Gambia

Background In rural sub-Saharan Africa, thatch roofs are being replaced by metal roofs. Metal roofing, however, increases indoor temperatures above human comfort levels, and thus makes it more likely that residents will not use an insecticide-treated bed net (ITN) at night. Whether the colour of a metal roof affects indoor temperature and human comfort was assessed. Methods Two identical, experimental houses were constructed with metal roofs in rural Gambia. Roof types were: (1) original bare-metal, (2) painted with red oxide primer or (3) white gloss, to reflect solar radiation. Pairwise comparisons were run in six, five-night blocks during the malaria season 2018. Indoor climate was measured in each house and multivariate analysis used to compare indoor temperatures during the day and night. Results From 21.00 to 23.59 h, when most residents decide whether to use an ITN or not, the indoor temperature of a house with a bare metal roof was 31.5 °C (95% CI 31.2–31.8 °C), a red roof, 30.3 °C (95% CI 30.0–30.6) and a white roof, 29.8 °C (95% CI 29.4–30.1). During the same period, red-roofed houses were 1.23 °C cooler (95% CI 1.22–1.23) and white roofs 1.74 °C cooler (95% CI 1.70–1.79) than bare-metal roofed houses (p < 0.001). Similar results were found from 00.00 to 06.00 h. Maximum daily temperatures were 0.93 °C lower in a white-roofed house (95% CI 0.10–0.30, p < 0.001), but not a red roof (mean maximum temperature difference = 0.44 °C warmer, 95% CI 0.43–0.45, p = 0.081), compared with the bare-metal roofed houses. Human comfort analysis showed that from 21.00 to 23.59 h houses with white roofs (comfortable for 87% time) were more comfortable than bare-metal roofed houses (comfortable for 13% time; odds ratio = 43.7, 95% CI 27.5–69.5, p < 0.001). The cost of painting a metal roof white is approximately 31–68 USD. Conclusions Houses with a white roof were consistently cooler and more comfortable than those with a bare metal roof. Painting the roofs of houses white is a cheap way of making a dwelling more comfortable for the occupants and could potentially increase bed net use in hot humid countries.

The Next Generation Fast Marine Access Solution

The long distance transport of offshore personnel has traditionally been undertaken by air. However, the desire for increased safety and efficiency in combination with the drive to lower operational cost in the offshore industry opens up new possibilities for fast marine access solutions. This article presents the development of the next generation Fast Crew Supplier that combines high transit speeds at high comfort levels with a reliable, safe and comfortable method of personnel exchange to the platform using a Walk-to-Work solution. The results of an integrated design approach are presented which are used to optimize the main transfer systems and their controls. It is shown that optimization of these systems allows a high workability for a Walk-to-Work solution on a fast and relatively lightweight ship in challenging wave conditions.